California senior-home inspectors told to not wear masks. Protection might ‘scare’ residents

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By Jason Pohl, The Sacramento Bee, March 20 2020

Wearing a medical mask can help limit the spread of some respiratory diseases. However, using a mask alone is not guaranteed to stop infections. Their use should be combined with other preventive measures. BY WORLD HEALTH ORGANIZATION | GETTY IMAGES PHOTO

California officials told adult and senior-living facility inspectors not to wear gloves or masks during site visits because supplies are already running low and donning the equipment might unnecessarily “scare” residents, according to interviews and an audio recording obtained by The Sacramento Bee.

Officials with the California Department of Social Services also told inspectors during the all-staff call on Thursday that constantly changing guidelines from state and federal health officials were sowing confusion about how best to prevent the spread of the new coronavirus. That uncertainty, they said, will likely continue as the pandemic intensifies in the coming weeks.

“It’s important for you not to go in wearing, donning, these protections because it will just scare everyone and it really, truly is not needed,” Ley Arquisola, a program administrator with DSS, said on the call with hundreds of inspectors and other staff. “So you need to be thoughtful as to how we’re going to use our equipment.

The department’s Community Care Licensing Division employees inspect and provide technical help to roughly 14,000 senior and elder-care facilities in the state. Amid the new coronavirus pandemic, California officials have tasked staff members to prioritize check-ins and site visits with each facility.

The visits are not detailed inspections. Instead, they are “walk-around” reviews to ensure the local administrators have posted hand-washing directions and are taking necessary precautions to slow the spread of COVID-19, officials said. The inspectors will not be going into residents’ rooms.

The licensing program analysts, or LPAs, will begin visiting facilities in areas with the most concentrated clusters of confirmed cases, including those in Santa Clara County and across Northern California.

Pamela Dickfoss, deputy director overseeing the Community Care Licensing Division, tried to allay staff concerns on the call. She pointed to Centers for Disease Control and Prevention guidelines against using masks except by those known to have the disease in an effort to stop the spread and for those health care workers with prolonged exposure to them.

“There’s a shortage of masks and we want to make sure there’s enough for health care workers,” Dickfoss said. “We don’t want to use them every time we go into a facility and use up the supply from those that really need them.”


On the call and in follow-up conversations with The Bee, Department of Social Services inspectors from across the state voiced concerns they were not being protected.

Some employees questioned why they couldn’t verify that facilities had the required hand-washing signs posted via video conferencing. One person asked about getting sanitizers to disinfect survey tools — DSS officials said those would be distributed “as soon as possible.”

And a Department of Social Services employee told The Bee he was concerned he might not show symptoms of the virus but could carry it into the facility anyway. Or, he said, he could carry it from an assisted living center with confirmed cases into his own home, potentially exposing his child or partner – an emergency health care worker.

Scott Murray, a DSS spokesman, said in a statement Thursday night that the guidance against inspectors wearing masks and gloves during visits was in line with the state health department’s guidance. Healthy people and those not providing care do not need them, he said, adding “the safety of our staff and the safety of residents in our licensed facilities is our paramount concern.”

Supply shortages and a rapidly spreading disease come at a critical juncture.

California is facing the frightening prospect of local health care networks being overwhelmed by a surge in patients sickened with COVID-19. Short equipment supplies have already forced some in the state to improvise solutions, including swim goggles and masks sewn in Los Angeles’ garment district.

And residents at assisted living centers and nursing homes are especially vulnerable.

The CDC in a report this week said nursing home employees in Washington who were infected helped spread the new coronavirus into other facilities where they also worked. At least 35 deaths have been connected to the COVID-19 outbreak at the Life Care Center of Kirkland.

“Limitations in effective infection control and prevention and staff members working in multiple facilities contributed to intra- and interfacility spread,” officials wrote.

Pat Leary, former DSS acting director who joined the Thursday call, cited the Washington case during Thursday’s call. Things can change rapidly, but it was important for site inspectors to be present now more than ever, she said.

“You need to be the center of calm,” Leary said. “When we’re going out to places where people might be afraid, you’re the person that’s there to say, ‘We’re here to help you. We’re here to help prevent what happened up in Washington State. Nobody wants to ever see something like that again.”